Women, Cancer, and Sexual Health

by Lynn Wang, MD

"What defines you?" That was my opening question for the women of a breast cancer support group where I was invited to speak about cancer and sexual health. In the past, I had mistakenly kept the question too broad, and the answers were various litanies of stage II cancer, cancer-free for three years, stage IV, metastatic to the bone …
This time, I reframed the question: No, not what defines your cancer. What defines you?

Their answers, and their fierceness, still touch me to the core:
I am a mother … a daughter … a wife … a grandmother … a friend …
What defines me is my relationship to my children … friends … partner … family …

It struck me that what defines us
all is connections – to ourselves and
to others. Connections are also the foundation of
sexual health.

The way I
describe sexual health is this: Think of your
sexual relationship as an egg. The outer shell is the physical connec­tion. Some important components of this are feeling good about the physical aspects of intimacy and communicating what works for you.

Touch is important because it stabilizes the
system – it provides a physical confirmation
of the emotional connection.

Dr. Lynn Wang

The yolk of the egg is the emotional connection. The way you may experi­ence this differs from woman to woman. Some women have described it as “feel­ing like we’re in the same boat, like we matter to each other, or like we’ve got each other’s backs.”

And last but not least is what con­nects the yolk and the outer shell, which is touch. Think of touch as a continuum, ranging from nonsexual touch, such as a hug or a peck on the lips, to sexual or erotic touch. Touch is important because it stabilizes the system – it provides a physical confirmation of the emotional connection. It can offer connectivity when sexual activity is not feasible.

These physical and emotional con­nections are important to many women and couples. Studies have confirmed that cancer survivors rate intimacy as an important part of their quality of life. And this finding holds true regard­less of age, cancer stage, or cancer type.

Many women have told me that, since their cancer treatment, they don’t feel good about themselves or their bodies. Or that sex hurts. For some women, these problems began even before cancer came along. Either way, these women and their partners stopped touching. One partner discouraged physical intimacy (maybe because
of low self-esteem or because cancer treatments left them exhausted), then the other partner grew tired of being rejected, and this then began to fray their emotional connection.

Some people can work this out on their own; others get stuck. And for good reason – cancer can complicate the already-complex emotional and physical interactions involved in main­taining a healthy sexual relationship.

If you’re feeling stuck, there is good news. More resources than ever before are available for women with cancer who are dealing with sexual health
issues. Cancer care teams are now
beginning to recognize the importance of sexual health in the overall plan of care. So ask your doctor for resources and referrals to sexual health profes­sionals, support groups, or educational materials that can help.

One of the many lessons I have learned from cancer survivors is that everyone’s journey is truly their own. And, cancer or no cancer, our relation­ship to ourselves and our partners is
a work in progress. Different people are drawn to working on different
aspects of “the egg,” and part of that process involves acknowledging what is working and what is not working
for you.

Now may not be the right time for you to work on your sexual relation­ship. The most important thing is to take care of yourself and your health. But when you are ready to address
sexual health issues, a good starting point is to understand where you came from, where you are, and where you want to go.

And so we end where we began: What defines you?

♦ ♦ ♦ ♦ ♦

Dr. Lynn Wang is a gynecologist and
American Association of Sexuality
Educators, Counselors, and Therapists–certified sexuality counselor and
educator at Main Line Gynecologic
Oncology in Wynnewood, PA.

To find certified sexual health providers in
your area, visit the American Association
of Sexuality Educators, Counselors, and
Therapists website at AASECT.org.

This article was published in Coping® with Cancer magazine,
September/October
2015.